Conditions & Treatments

Strokes

A stroke is a condition in which the blood supply to any part of the brain is interrupted by a blockage in a blood vessel or if the blood vessel bursts open (see cerebral aneurysm). The blockage may come about because of clot formation in an already narrowed blood vessel or a clot from somewhere else in the body may travel to the brain and block a small artery.

Although strokes in children are not common, they happen more than might be expected–possibly as many as 9,000 incidents a year. And in newborns, the estimates suggest that strokes may occur surprisingly at approximately 25 per 100,000 infants.

Causes

Strokes in children seem to occur as a result of a variety of conditions:

Previously undiagnosed heart malformations

Heart diseases

Infections

Complications of other illnesses, such as sickle cell disease, in which misshapen blood cells obstruct circulation

Whiplash injury to the neck, which damages an artery and leaves it vulnerable to blood clots

Plus many other possibilities, including those that are simply unknown

Diagnosis

One of the main problems related to the diagnosis of strokes in children is often the family members are not aware that this condition can sometimes occur in children and so delay seeking treatment. Furthermore, sometimes even physicians may not immediately consider the possibility of a stroke. But when a stroke is suspected, a number of studies may be used to verify the suspicions:

Vascular ultrasound

CT

Magnetic resonance imaging (MRI)

Blood tests

DSA cerebral angiogram

Echocardiogram

Lumbar puncture

Symptoms

Each child may experience symptoms differently. Symptoms may include:

Severe headache

Slurred speech

One-sided paralysis or difficulty walking normally

Seizures

Vision disturbances

Treatment

Strokes in children are treated in a variety of ways, depending on many different factors. In the case of ischemic strokes, immediate treatment is likely to consist of anticoagulant medications (blood thinners), such as aspirin, heparin and warfarin.

Though each child is unique, in most cases long-term treatment such as physical therapy, occupational therapy and speech/language therapy will probably be needed, along with follow-up by a pediatrician, a neurologist and a physical therapy professional.

Long-term Outlook

Studies suggest that the risk of another stroke occurring ranges from 6 to 30%. Most occur within six months after the first stroke. Children that have risk factors such as a heart or blood vessel defect, sickle cell disease or a blood clotting abnormality are at the highest risk for recurrence. Studies are being done to see if medical treatments such as aspirin can reduce the risk of recurrence.